Chronic Diffuse Lung Diseases

Published on Jan 1, 2018
· DOI :10.1016/B978-0-323-44284-8.00008-9
Mikiko Hashisako8
Estimated H-index: 8
Junya Fukuoka37
Estimated H-index: 37
+ 0 AuthorsMaxwell L. Smith1
Estimated H-index: 1
Abstract Chronic diffuse lung diseases involve a spectrum of nonneoplastic inflammatory conditions that affect the lung parenchyma. This chapter reviews the spectrum of disease including idiopathic interstitial pneumonias, pulmonary manifestations of systemic collagen vascular disease, diffuse eosinophilc lung disease, drug-associated lung disease, diffuse granulomatous lung disease, and a variety of miscellaneous diseases that defy classification. Individual entities are reviewed, followed by a section highlighting a practical approach to the four most common patterns of injury encountered in practice.
Context.— Three distinct patterns of pulmonary fibrosis, including usual interstitial pneumonia, fibrotic nonspecific interstitial pneumonia, and airway-centered fibrosis, can be identified on surgical lung biopsies. Objectives.— To compare the pathologic definitions, clinical and radiographic presentations, etiologies and differential diagnoses, treatments, and prognoses of usual interstitial pneumonia, fibrotic nonspecific interstitial pneumonia, and airway-centered fibrosis patterns, and to a...
22 CitationsSource
#1Aryeh Fischer (University of Colorado Denver)H-Index: 36
#2Katerina M. Antoniou (UoC: University of Crete)H-Index: 30
Last. Vincent CottinH-Index: 60
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Many patients with an idiopathic interstitial pneumonia (IIP) have clinical features that suggest an underlying autoimmune process but do not meet established criteria for a connective tissue disease (CTD). Researchers have proposed differing criteria and terms to describe these patients, and lack of consensus over nomenclature and classification limits the ability to conduct prospective studies of a uniform cohort. The “European Respiratory Society/American Thoracic Society Task Force on Undiff...
407 CitationsSource
In order to determine if the diagnostic yield of the transbronchial lung biopsy in sarcoidosis is dependent upon the number of biopsies, a study was designed to examine individual specimens from 6 biopsies in patients with Stage II sarcoidosis. It was found that the probability of obtaining a positive specimen per biopsy was 46%, and this percentage remained constant for each biopsy. The diagnostic yield followed a logarithmic curve, gradually increasing from 1 through 4 biopsies until about 90%...
156 CitationsSource
280 CitationsSource
We describe 6 patients with chronic interstitial lung disease in whom open lung biopsies showed respiratory bronchiolitis. The patients ranged from 28 to 46 yr of age (mean, 36 yr) and included 5 men and 1 woman. All were heavy cigarette smokers. Five had respiratory symptoms, most commonly cough and dyspnea. Diffuse interstitial infiltrates were seen on chest radiographs in 5 and bibasilar atelectasis in 1. Pulmonary function tests showed mild to moderate restriction in 4 and decreased diffusin...
250 CitationsSource
To ascertain the diagnostic reliability of transbronchial biopsy (TBB) a prospective comparison with open lung biopsy was made. All patients with undiagnosed diffuse infiltrative (interstitial) lung disease had a TBB. When this was characteristic of tumor, sarcoidosis, or infection, no additional biopsy was deemed necessary. In all other patients, an open biopsy was performed. Between January 1976 and May 1980, among 176 patients with interstitial disease, 60 (34.1%) required lung biopsy. Transb...
165 CitationsSource
This report is based on 43 cases where a diagnosis of either bronchiolitis obliterans with organizing pneumonia (BOOP), usual interstitial pneumonia (UIP), or small airways disease (SAD) was established by lung biopsy. The severity of histologic abnormalities in the peripheral airways and interstitial spaces were measured on these biopies using semiquantitative techniques and compared with the clinical data available in 42 of 43 cases, preoperative chest radiographs in 31 of 43, and preoperative...
123 CitationsSource
#1Lilian T. Kuranishi (UNIFESP: Federal University of São Paulo)H-Index: 4
#2Kevin O. Leslie (Mayo Clinic)H-Index: 43
Last. Carlos Alberto de Castro Pereira (UNIFESP: Federal University of São Paulo)H-Index: 23
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Background Airway-centered Interstitial Fibrosis (ACIF) is a common pathologic pattern observed in our practice.
27 CitationsSource
#1WenBin Xu (Peking Union Medical College)H-Index: 1
#2Yi Xiao (Peking Union Medical College)H-Index: 1
Last. JuHong Shi (Peking Union Medical College)H-Index: 1
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Background Studies have shown that nonspecific interstitial pneumonitis (NSIP), even when initially diagnosed as an idiopathic form of the disease, might be associated with an autoimmune background that later reveals itself as an organ-specific or a systemic autoimmune disease.
11 CitationsSource
#1Paul J. Maglione (ISMMS: Icahn School of Medicine at Mount Sinai)H-Index: 15
#2Jessica Overbey (ISMMS: Icahn School of Medicine at Mount Sinai)H-Index: 15
Last. Charlotte Cunningham-Rundles (ISMMS: Icahn School of Medicine at Mount Sinai)H-Index: 75
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51 CitationsSource
Cited By11
#1L M Buja (University of Texas Health Science Center at Houston)H-Index: 57
#2Dwayne A. WolfH-Index: 2
Last. Biswajit Kar (University of Texas Health Science Center at Houston)H-Index: 32
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This paper collates the pathological findings from initial published autopsy reports on 23 patients with Coronavirus Disease 2019 (COVID-19) from 5 centers in the United States of America, including 3 cases from Houston, Texas. Findings confirm that COVID-19 is a systemic disease with major involvement of the lungs and heart. Acute COVID-19 pneumonia has features of a distinctive acute interstitial pneumonia with: a diffuse alveolar damage (DAD) component, coupled with microvascular involvement ...
133 CitationsSource
#1Kiminori Fujimoto (Kurume University)H-Index: 31
Impairments/comorbidities of the respiratory system are important extra-articular features in patients with rheumatoid arthritis (RA) and represent a major cause of mortality. Interstitial lung disease (ILD) in RA (RA-ILD) and other types of connective tissue diseases (CTDs) is categorized using the international consensus classification of an idiopathic interstitial pneumonia. Unlike other types of CTDs, RA-ILD most often shows a usual interstitial pneumonia-like pattern on high-resolution comp...
Context.— Three distinct patterns of pulmonary fibrosis, including usual interstitial pneumonia, fibrotic nonspecific interstitial pneumonia, and airway-centered fibrosis, can be identified on surgical lung biopsies. Objectives.— To compare the pathologic definitions, clinical and radiographic presentations, etiologies and differential diagnoses, treatments, and prognoses of usual interstitial pneumonia, fibrotic nonspecific interstitial pneumonia, and airway-centered fibrosis patterns, and to a...
22 CitationsSource
#1Keith C. Meyer (UW: University of Wisconsin-Madison)H-Index: 44
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Acute fibrinous and organising pneumonia (AFOP) is a histopathologic variant of acute lung injury that has been associated with infection and inflammatory disorders and has been reported as a complication of lung transplantation. A retrospective chart review was performed for all patients transplanted at the University of Wisconsin Hospital and Clinics from January 1995 to December 2013 (n = 561). We identified 6 recipients whose clinical course was complicated by AFOP. All recipients were found...
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#1Nobuhiko Nagata (Fukuoka University)H-Index: 17
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Last. Doo Hyun Chung (SNU: Seoul National University)H-Index: 49
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